Prolapse Flashcards Preview

repro > Prolapse > Flashcards

Flashcards in Prolapse Deck (32)
1

definition of urinary incontinence?

involuntary loss of urine which can be demonstrated and is a social or hygienic problem

2

leakage of urine during raised intra abdominal pressure?

stress urinary incontinence

3

leakage associated with urgency, usually with detrusor activity?

OAB

4

what would detrusor hypotonia cause?

voiding difficulties

5

symptoms of urinary incontience?

precipitated by stress or urgency. Irritative symptoms:frequency, urgency, nocturne, dysuria
voiding difficulties: poor stream, incomplete emptying

6

most common form of incontinence?

stress incontinence (48 percent of women)

7

how would you investigate incontinence?

urinalysis, bladder chart, URODYNAMICS

8

useful investigation to differentiate between stress incontinence and urge?

urodynamics

9

urodynamics contains uroflowmetry and cystometry

y

10

what is flow rate?

measures peak flow, mean flow and voided volume

11

cystometry?

a method by which the pressure/volume relationship of the bladder is measured during filling, provocation and voiding

12

what would stress in look like on graph?

spikes of urine flow after cough or sneeze

13

overactive bladder?

involuntary detrusor contractions

14

bladder outlet obstruction?

high detrusor/bladder pressure. low flow arte/no flow rate

15

treatment of stress incontinence?
stress - dul

lifestyle - stop smoking, weight loss, avoid caffeine drinks etc. physio for pelvic floor retraining.

16

which drug (combined noradrenaline and serotonin repute inhibitor) increases intraurethra closure pressure?

duloexetine

17

surgical procedures for stress incontinence?

low tension vaginal tape, intraurethral injection, artificial sphincters, colposuspension

18

treatment of overactive bladder
OAB - oxy

avoid caffeinated drinks, bladder training. Oxybutanin (anti muscarinic drugs)
OAB - oxybutanin

19

surgical? (rarely used)

botox injections

20

pelvic organ prolapse. classifications?

1st degree (in vagina)
2nd degree (at introits)
3rd degree (outside vagina)
procidentia - completely outside vagina

21

term for prolapse completely outside vagina?

procidentia

22

types of pelvic organ prolapse?

urethrocele (urethra), cytocele (bladder), rectocele(rectum) enterocele (pouch of douglas containing small bowel) vaginal vault, uterus and cervix

23

symptoms of uterovaginal prolapse?

backache, ulceration of procidentia, coital difficulties, urinary retention, constipation,

24

management of prolapse?

rassure, avoid heavy lifting, lose weight, stop smoking, reduce constipation, vaginal oestrogen, only if symptomatic atrophic vaginitis, physiotherapy

25

women unfit for surgery or awaiting surgery?

pessarie

26

when do you consider surgical management?

only after failed conservative management

27

sacrospinous ligament fixation - what is this?

securing vaginal vault to sacrospinous ligament using sutures

28

what group of people have problem with oxybutanin?

old people?

29

biggest problem with oxybutanin?

dry cough

30

what type of drug is oxybutanin?

an antimuscarinic

31

how long does oxybutanin take to start working?

4 weeks

32

whats a better option than oxybutanin for older patients?

tolteradine